Circulation. 2003;107:1647-1652
Published online before print March 17, 2003, doi: 10.1161/01.CIR.0000058171.62847.90
Published online before print March 17, 2003, doi: 10.1161/01.CIR.0000058171.62847.90
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(Circulation. 2003;107:1647.)
© 2003 American Heart Association, Inc.
Basic Science Reports |
Noninvasive Assessment of Left Ventricular Force-Frequency Relationships Using Tissue Doppler–Derived Isovolumic Acceleration
Validation in an Animal Model
From the Cardiothoracic Unit, Great Ormond Street Hospital for Children, NHS Trust, London, UK (M.V.); Division of Cardiology, Hospital for Sick Children, Toronto, Canada (M.M.H.C., J.L., A.N.R.); Department of Experimental Research and Cardiology, Skejby Hospital, Aarhus, Denmark (S.B.K., M.R.S., K.S.); and Papworth Hospital, Cambridge, UK (P.A.W.).
Correspondence to Dr Andrew Redington, Head, Division of Cardiology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario M5G 1X8 Canada. E-mail andrew.redington{at}sickkids.ca
Background— We have demonstrated that myocardial acceleration during isovolumic contraction (IVA) is a sensitive index of right ventricular contractile function. In this study, we assessed the usefulness of IVA to measure left ventricular (LV) contractile function and force-frequency relationships in an experimental preparation.
Methods and Results— In study 1, we examined 6 pigs by use of tissue Doppler imaging of LV free wall and simultaneous measurements of intraventricular pressure, volume, maximal elastance (Emax), and dP/dtmax by conductance catheterization. Animals were paced via the right atrium at a rate of 130 bpm. IVA was compared with elastance during contractility modulation by esmolol and dobutamine and assessed during preload reduction and afterload increase. In study 2, in 6 more pigs, force-frequency data were obtained during incremental atrial pacing from 120 to 180 bpm. Study 1: Esmolol led to a decrease in IVA and Emax (P<0.03 and <0.02, respectively), both of which increased during dobutamine infusion (P<0.02 and <0.03, respectively). IVA was unaffected by significant (P<0.001) acute reduction of LV volume and a significantly increased LV afterload (systolic pressure increase, P<0.001). Study 2: There was a positive correlation between IVA and dP/dtmax (r2=0.92, P<0.05). As heart rate was increased from 120 to 160 bpm, there were significant increases in both IVA and dP/dtmax (P<0.0004 and P=0.02, respectively). Over the same range of heart rates, there was no significant change in Emax (P=0.22).
Conclusions— IVA is a measurement of LV contractile function that is unaffected by preload and afterload changes within a physiological range and can be used noninvasively to measure LV force-frequency relationships.
Key Words: contractility • echocardiography • ventricle
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